By Monica Tentori, Post-Doctoral Scholar, FitBaby
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In the FitBaby project, we are working on developing a comprehensive solution that will show relevant observations of daily living (ODLs) for both clinicians and parents of pre-term infants. As part of this effort, we started talking about how activities of daily living (ADLs) are related to the concept of ODLs and where there might be some tension between these two ideas.
In eldercare, a common goal is measuring and understanding ADLs: The things we normally do in daily living, including any daily activity we perform for self-care. The beauty of ADLs is that they allow us to assign a functional score on a common scale. ODLs on the other hand, are sentinel observations that lack an explicit tie between indicator and function.
What follows is a typical response from the mother of a low birth weight infant describing an average day:
My girls usually get up about 7:30 and play around on the floor for maybe half an hour to an hour - reading books and playing with toys. Breakfast then takes about 30 minutes because they’re starting to get into finger food. They eat their yogurt or cereal and then they play with the puffs. They play for another hour at home, usually by themselves at that point, in their room. And then they take a nap for about an hour. After that, they have their lunch. After lunch, we go for a walk to the park for about two hours. When we come back, they get their snack and milk and take another nap. In the evening we play with their toys, read books and take a bath. They then go to sleep.
What you see here is a lot of discussion about what we are classifying as baby ADLs (eating, bathing, playing, and so on) and almost nothing about what we might typically call ODLs (sleep quality, mood, appetite and so on). Indeed, when analyzing our data from interviews and focus groups over the last several months, we found out that from 275 occurrences of indicators actually related to function associated with the tracked ODLs by moms, 75% include babies’ ADLs.
Our team isn’t the only one exploring connections between ADLs and ODLs. The Embedded Assessment project of CMU is observing things like opening a pillbox, making tea, and other standard activities one might measure to detect cognitive decline in elders. In many ways, tracking data on how well an elderly patient performs these activities, or at least how consistently, is both an ADL and a sort of meta-ODL that captures several ODLs at once.
To me, it seems as though ADLs can be used as an instrument to monitor some ODLs while ODLs can provide context and meaning to caregivers about ADLs.
What are your thoughts?
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